Abstract
Introduction:
The temporary implantable nitinol device (iTIND) is a novel minimally invasive surgical therapy (MIST) for BPH. Globally, it is typically performed with a rigid cystoscope under general anesthesia or sedation. In this video, we demonstrate safe iTIND deployment with flexible cystoscopy, along with practical tips and tricks for practitioners.
Equipment required. Flexible Cystoscope—preferably with an in-built suction function. Guidewire—preferably a hybrid guidewire. Access sheath, or an open-ended silicon catheter. iTIND device.
We used the Pusen Single-Use Cystoscope with Integrated Suction, BD Soloplus Guidewire, and Olympus 13/15 Fr 24 cm Uropass Ureteral Access Sheath.
Procedural Steps. Performing Standard Flexible Cystoscopy. Hybrid Guidewire Insertion. Insertion of Access Sheath. Removal of Inner Stylet of Access Sheath. Insertion of iTIND through Access Sheath. Reintroducing Flexible Cystoscopy. Positioning of iTIND Device. Partial Bladder Emptying and Withdrawal of Cystoscope.
Results:
Total operative time was 4 minutes 30 seconds. The patient was discharged well on the same day. The iTIND was removed uneventfully on day 7. The patient had no sexual side effects or complications from the procedure.
Conclusion:
The use of flexible cystoscopy for iTIND insertion represents a step forward in exploring its potential to be done in the outpatient setting. With sufficient experience, the iTIND device can be safely placed with minimal resource utilization using flexible cystoscopy, potentially under local anesthesia in the office setting. This highlights the promise of iTIND as an “off-the-shelf” option for BPH treatment.
Runtime of video: 3 mins 37 secs.
Music: “Education Background Music,” sourced from Youtube (https://youtu.be/pSZKl8dvdcc?si=KAk5rclrtT39eA_m), free for non-monetized use.
Authors have received and archived patient consent for video recording/publication in advance of video recording of the procedure.
Author Disclosure Statement:
Dr. Y.Q.T. has acted as a consultant for Olympus Corporation and Becton Dickinson Holdings.